‘Black box’ offers troubling insights into risk of surgical errors

‘Black box’ technology designed to record surgeries suggests that errors occur frequently and often go unnoticed, regardless of a surgeon’s experience.

People undergoing surgery in Mount Laurel generally expect to receive competent care and leave the procedure in better health. Sadly, though, surgical errors that have life-changing consequences are not uncommon. According to research published in Surgery, "never events," or mistakes that should never excusably occur, happen about 4,000 times annually in the U.S. Other
errors related to surgery may occur even more frequently.

To address this threat, researchers in Canada are now developing an advanced system to monitor surgeries. According to CNN, the "black box" records surgical operations as well as interactions between surgical staff. Someday, the black box may provide live feedback to surgeons, preventing harmful errors. Currently, the device, which is still under development, is shedding light on the significant risk of surgical errors.

Mistakes common, often overlooked

During early tests, the box was used to monitor laparoscopic surgeries performed at a Toronto hospital. After recording 40 of these surgeries, researchers analyzed the recordings to identify common errors. Researchers found that each surgeon made an average of 20 errors per procedure. These errors weren't necessarily grave mistakes that resulted in
patient injuries. Instead, researchers counted every deviation from standard protocol as an error.

It's widely believed that more experienced surgeons are less likely to make mistakes. However, the researchers found that errors occurred at roughly the same rate among surgeons of all ages. Experience didn't help surgeons identify their mistakes, either. The researchers actually found that all of the surgeons were oblivious to most of the mistakes that they made.

This failure to recognize errors may reflect a broader characteristic of operating room culture. As The Toronto Star explains, errors typically aren't called to attention or discussed among surgeons. Practicing surgeons may receive limited feedback and therefore be unaware of potentially harmful mistakes. The inventor of the black box hopes that the device will encourage a shift in surgical culture. This, in turn, could lead to better outcomes for patients.

Reducing unnecessary surgical mistakes

The black box has already shown promise to identify common surgical errors. After reviewing recordings of 80 gastric bypass surgeries, the researchers identified two problematic steps in the procedure. Surgeons made 86 percent of observed errors during those steps. The researchers are now using this finding to create educational materials that seek to prevent similar mistakes. On a larger scale, similar measures could help reduce surgical injuries stemming from common errors.

According to The Philadelphia Inquirer, numerous hospitals have expressed interest in utilizing a black box. However, the device may not offer a reasonable solution for hospitals that provide a wide range of procedures. So far, the device has only been used to monitor one type of surgery. It may not offer such useful feedback for more unusual or rare procedures. This means that, even if the use of black boxes becomes widespread, the risk of errors during some surgeries may remain significant.

Recourse for surgical errors

The victims of surgical errors may be entitled to compensation for economic and personal losses. Victims must be able to show that they suffered injuries as a direct result of substandard medical care. In New Jersey, victims must prove that care was substandard through the testimony of an expert witness. This witness must practice the same specialty as the professional responsible for the injury.

In the future, if surgical procedures are recorded in greater detail, establishing a surgeon's negligence may become simpler. At present, though, proving medical negligence can be challenging, even when patients suffer serious injuries. Anyone who has suffered harm due to surgical errors should consider meeting with an attorney for advice on pursuing recourse.

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